Purpose: With the growing popularity of upper lid blepharoplasty, there have been increasing reports of unsatisfactory outcomes that have necessitated a revision surgery. This study aimed to evaluate aesthetic outcomes of surgical correction of the high eyelid fold using a pretarsal orbicularis oculi flap and to highlight the key practice points of this surgical procedure in secondary blepharoplasty.

Methods: A retrospective study of 31 consecutive Chinese patients who underwent revision surgeries between January 2013 and December 2015 was undertaken through a review of medical records. Read More

Eyelid shape is one key distinctive feature of the Asian eye. The presence of epicanthal folds is a common eyelid defect of Asians. Different surgical techniques have been developed to correct epicanthal folds. Read More

Authors:

Background: Rejuvenation of aging eyelids is one of cosmetic changes to the individual to create the appearance of youth. Tightening treatment of eyelid by ultrasonic heat could possibly develop acute eye injury, including acute increase of IOP, cataract and rarely myopia.

Background: Korean males and a few females desire to have larger eyes; however, they often wish to enlarge their eyes and conceal their double eyelids. This paper attempts to describe how to make the eyes bigger and brighter without showing double-fold eyelids.

Methods: The authors performed cosmetic ptosis correction in 121 cases from April 2013 to December 2017. Read More

Background: Direct damage to the superior rectus (SR) muscle insertion following upper lid blepharoplasty has not been reported. We document a rare case of vertical diplopia due to direct damage to the SR muscle insertion following cosmetic upper lid blepharoplasty.

Case Presentation: We describe a case of 24-year-old woman with Asian eyelid. Read More

The video illustrates the steps of Asian blepharoplasty of the upper eyelids, using the author's principle of beveled approach and trapezoidal debulking of preaponeurotic platform to allow safe access, minimization of wound injury, and creating a physiologically dynamic crease, without resorting to the use of buried sutures. Read More

Authors:

Objective: To introduce a modified transsection and longitudinal suture in epicanthoplasty and summarize its effectiveness.

Methods: The clinical data of 119 patients underwent epicanthoplasty with modified transsection and longitudinal suture and with a follow-up time over 6 months between February 2014 and December 2016 were retrospectively analyzed. There were 8 males and 111 females with an average age of 22. Read More

Purpose: Among multiple influential factors affecting facial symmetry, the role of soft tissue is often overlooked. Skin and skeletal differences between Asian and Caucasian people also require the adaptation of current techniques for Asian patients. This article aimed to explore the ability of individual facelift techniques to improve facial symmetry and reset youthful eye in Asian people, while a new method, called the grid method, was tried to evaluate the improvement in facial symmetry. Read More

Authors:

Background: In the malar region, the SMAS flap can be thin and tear easily, making it difficult to securely fix it. And the surgical anatomy of the region may be unclear and confusing. The authors performed an anatomical study on the location of the lateral margin of the orbicularis oculi muscle (OOM) and the origin of the zygomaticus major muscle (ZMM) when using a high-SMAS facelift with finger-assisted spaces dissection technique, which included elevation of the SMAS flap with OOM. Read More

Background: Epicanthoplasty combined with double-eyelid blepharoplasty is one of the most popular cosmetic procedures in Asians. However, the postoperative medial canthal scar is a concerned issue. Here the authors adopted some modifications of Z-epicanthoplasty to minimize the canthal scar. Read More

The medial epicanthal fold is one of the racial anatomic characteristics of Asians. As medial epicanthoplasty has become one of the most common cosmetic surgeries among Asians, the need for revision of overcorrected medial epicanthus also increased. In revision medial epicanthoplasty, an autologous tissue graft to the subcutaneous plane is used to reduce postoperative scar. Read More

Authors:

Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.

Background: Double eyelidplasty can enhance the eye size and facial attractiveness of Asian individuals with single eyelids. The authors hypothesize that a supratarsal fold can induce an eye size assimilation illusion to enhance eye dimensions and aesthetics, and seek to define the optimum vertical proportion between a supratarsal fold and the eye fissure associated with maximal induction of the size assimilation illusion.

Methods: A photometric study of the replicated photographs of ten female Taiwanese patients after double eyelidplasty was designed. Read More

Background: Many women in Asian countries chase larger and brighter eyes, but to most Asian people only double eye plasty and epicanthoplasty is not enough. As a result, aesthetic lateral canthoplasty, another procedure to lengthen the palpebral fissure, is becoming more and more popular. However, the current procedure of aesthetic lateral canthoplasty has many potential complications, restricting the wide application of this procedure. Read More

Authors:

Dept. of Plastic and Reconstructive Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, South Korea. Electronic address:

Background: Sunken upper eyelid is a commonly found deformity among Asians, mostly due to the aging process and excessive orbital fat removal during oriental blepharoplasty procedures. This deformity is frequently accompanied by multiple, poorly defined upper eyelid folds and blepharoptosis. To date, autologous fat graft has been the treatment of choice for this group of patients. Read More

Background: Double eye-lid surgery is one of the most popular performed aesthetic procedures in young Asians. Reliable measurement of patient reported outcomes is crucial for facial aesthetics. The FACE-Q is a new patient-reported outcome tool (PRO) composed of numerous independently functioning scales and checklists designed to measure outcomes. Read More

Background: Presently, many techniques have been described to make the epicanthal fold less prominent. However, visible scarring remains a major concern in most techniques. The aim of this study was to develop a novel design using concealed incisions with minimal tension. Read More

Authors:

From the *Eve Plastic Surgery Clinic; †Department of Ophthalmology, Ewha Womans University, School of Medicine; and ‡Department of Plastic Surgery, Ewha Womans University Mokdong Hospital, Seoul, South Korea.

Purpose: We had reported the surgical outcome of reverse skin redraping technique for restoration of previously performed epicanthoplasty. In this study, we introduce a modified reverse skin redraping technique that added mini-epicanthoplasty in patients with unsatisfactory results after epicanthoplasty.

Methods: Three hundred twenty-four patients (288 female and 36 male patients) who had unsatisfied results with previous epicanthoplasty and that were treated with our modified restoration surgery were included in this study. Read More

Authors:

The popularity of surgical modifications of race-typical features among Asian women has generated debates on the ethical implications of the practice. Focusing on blepharoplasty as a representative racial surgery, this article frames the ethical discussion by viewing Asian cosmetic surgery as an example of medicalization, which can be interpreted in two forms: treatment versus enhancement. In the treatment form, medicalization occurs by considering cosmetic surgery as remedy for pathologized Asian features; the pathologization usually occurs in reference to western features as the norm. Read More

Background: Upper blepharoplasty is indicated in Asians for double-eyelid fold creation, periorbital rejuvenation, and functional visual field improvement. This article introduces a technical classification for blepharoplasty methods and investigates approaches to evaluate its outcomes.

Methods: Of 535 patients undergoing aesthetic upper blepharoplasty in our institution in 1998-2011, 136 patients who were well followed up were retrospectively reviewed and categorized into four groups according to the techniques employed. Read More

Background: Fat-preserving lower blepharoplasty techniques and filling techniques using autologous or non-autologous materials are increasingly used to treat tear trough deformity. However, there has been no definitive comparison of the results of fat repositioning versus autologous fat grafting for this condition. The authors used statistical analysis to compare the results of the two methods. Read More

Authors:

*Lee Jung Aesthetic Plastic Surgery Clinic †Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul ‡Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon §Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine ||Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea.

Reduced horizontal length of the palpebral fissure is a distinctive characteristic of Asian eyelids, and aesthetic lateral canthal lengthening techniques have been performed for a refinement. The aim of this study is to describe a novel lateral canthoplasty using tarso-conjunctival advancement with a lid margin splitting procedure on the upper eyelids and to report the postoperative results. From December 2011 to June 2014, patients who underwent lateral canthoplasty using the tarso-conjunctival advancement procedure for aesthetic purposes were reviewed retrospectively. Read More

Background: The creation of a superior palpebral crease has been the most popular plastic surgery procedure in Asians for several decades. The most important criterion for judging the success of this procedure is the achievement of the desired size and shape of this crease or the perfect crease width. However, the determinants of crease width remain unclear, which may account for the high rate of unsatisfactory results. Read More

Authors:

From the *Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA; †Department of Energy and Electrical Engineering, Korea Polytechnic University, Siheung; and ‡Ohkims Plastic Surgical Clinic, Ilsan, South Korea.

Background: The ability to correct unnatural-appearing, high, and deep double eyelid folds has been limited by the lack of redundant upper eyelid skin and the presence of prior incision line scars in patients.

Methods: From January 2000 to September 2011, 256 patients with high and deep double eyelid folds underwent our fold-lowering procedure. The first dissection was made at the superficial layer between the orbicularis oculi muscle and orbital septum/retroorbicularis oculi fat. Read More

Background: Epicanthal folds and single eyelids are considered characteristic East Asian traits. This study describes a new approach to medial epicanthoplasty based on an orbicularis oculi muscle resection technique and reports the surgical outcomes in Chinese patients.

Background: Blepharoplasty is a common aesthetic surgery performed worldwide. In Asians, too high eyelid folds after blepharoplasty cause an unsatisfactory aesthetic outcome that is difficult to correct. In this article, the authors propose surgical techniques to correct the high eyelid fold after blepharoplasty. Read More

Background: The presence of mild or moderate medial epicanthus is typical in Asian patients. Numerous epicanthoplasty techniques have been described previously. However, these methods usually leave obvious scars in the medial canthal area. Read More

Authors:

Objective aesthetic criteria are important for patient evaluation and analysis during aesthetic surgeries, while successful aesthetic surgeries must take into account the underlying ethnic differences. The aim of this study is to help surgeons and scientists better plan facial aesthetic surgeries and understand the aesthetic needs according to different patients by reviewing and comparing the current aesthetic principles and preferences in Caucasian and East Asian populations. PubMed and The Cochrane Library were searched using keywords regarding anthropometric measurements. Read More

Purpose: Literature on palpebral springs is scarce, and even more so for the Asian population. In this study, the authors evaluated their experience with palpebral spring placement for paralytic lagophthalmos in an Asian population. The authors report the unique challenges encountered due to the distinctive features in Asian eyelids and how they overcome them. Read More

Authors:

Seoul, Republic of Korea; and Bangkok, Thailand From the Division of Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK PLUS Project, Yonsei University College of Dentistry; and the Chula Soft Cadaver Surgical Training Center and Department of Anatomy, Faculty of Medicine, Chulalongkorn University.

Background: A detailed analysis of the topography of the inferior medial palpebral artery is needed to optimize the safety and efficacy of pretarsal roll augmentation.

Methods: Thirty-one hemifaces from 13 Korean and 8 Thai cadavers (15 male and six female cadavers) were dissected. The distributions of the inferior medial palpebral artery were determined with respect to the superior medial palpebral artery and the supratrochlear artery. Read More

An accurate understanding of the anatomy of the levator palpebrae superioris aponeurosis (LPSA) is critical for successful blepharoplasty of aponeurotic ptosis. We investigated the macroscopic and microscopic anatomy of the LPSA.This prospective live gross anatomy study enrolled 200 adult Chinese patients with bilateral mild ptosis undergoing elective blepharoplasty. Read More

Authors:

a Department of Plastic and Reconstructive Surgery , Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, People's Republic of China.

Introduction: This study used the SmartLipo 1064-nm system to remove herniated orbital fat tissue to improve lower eyelid appearance. A retrospective review of 128 patients was performed to evaluate the size of prominent fat pads and complications.

Materials And Methods: Altogether, 128 patients underwent a procedure using the SmartLipo 1064-nm system via postseptal access, which helped locate fat tissue more precisely. Read More

Background: The epicanthal fold is a distinct characteristic of the Asian upper eyelid, which may impair the beauty of the eyes and the outcome of double eyelid blepharoplasty. Although many surgical procedures have been reported, their main drawbacks include a conspicuous scar in the medial canthal area and an unnatural palpebral contour. We devised a novel surgical approach to correct the epicanthal fold with acceptable scarring. Read More

Authors:

Objective: To investigate the role of corneal exposure ratio in eyelid aesthetic assessment through the measurement by Photoshop pixel method in beauties and patients with double eyelid blepharoplasty.

Methods: 30 cases of female beauties and 43 cases with double eyelid blepharoplasty(23 cases with suture method and 20 cases with incision method) underwent measurement of corneal exposure ratio by Photoshop pixel method before operation and half a year after operation. The results were analyzed by SPSS 16. Read More

Authors:

Purpose Of Review: Purpose of review is to emphasize the clinical significance of the epicanthal fold when evaluating Asian eyelids. Advances in Asian eyelid research have improved the understanding of the epicanthal fold and highlighted key steps to performing successful epicanthoplasty. Up-to-date epicanthoplasty surgical techniques are also discussed. Read More

Purpose: To evaluate the relationship between the incidence of lower eyelid epiblepharon and body mass index in Chinese children and report the outcomes of a rotating suture technique or the L-plasty procedure aimed at correcting the structural anomalies.

Methods: The medical records of patients treated surgically, with either rotating suture procedure or L-plasty, for lower eyelid epiblepharon were reviewed retrospectively and compared with an age-matched control group of children without epiblepharon. Body mass index (BMI) was calculated as weight in kilograms divided by the square of height in meters. Read More

Background: Direct brow lift surgery remains popular among Asian women despite its disadvantages. The traditional direct brow lift by a supra-brow incision is not suitable for Asian women because of their unique facial features, such as higher eyebrows, wider upper eyelids, and more orbital fat. Therefore, we designed a novel brow lift technique via a supra-brow combined with an infra-brow approach for Asian women. Read More

Authors:

This review aims to identify (1) sources of knowledge and (2) important themes of the ethical debate related to surgical alteration of facial features in East Asians. This article integrates narrative and systematic review methods. In March 2014, we searched databases including PubMed, Philosopher's Index, Web of Science, Sociological Abstracts, and Communication Abstracts using key terms "cosmetic surgery," "ethnic*," "ethics," "Asia*," and "Western*. Read More

Authors:

From the *Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; and †Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland.

Purpose: To describe a medial epicanthoplasty technique using a stepwise, customized design and to review the outcome in Asian patients after the treatment of medial epicanthal fold.

Design: Retrospective, noncomparative and interventional case series with the introduction of a new surgical technique.

Purpose: In Asian patients, lateral hooding in the aging upper eyelid is prominent and frequently seen. Removal of the redundant skin of this region during classic blepharoplasty tends to produce a resultant prolonged scar. Furthermore, as the height of the eyelid skin excision increases, suturing of the thick upper skin to the thin pretarsal skin can result in upper lid fullness. Read More

Authors:

Background: Natural adhesion between the levator aponeurosis and the subcutaneous layer in the upper lid is essential for an aesthetically pleasing double eyelid. The study aims to emphasize the outer fascia of orbicularis oculi muscle (OFOOM) as a fixation point on the double eyelid surgery.

Methods: The authors examined the detailed anatomy of the anterior lamella microscopically during 28 cases of primary double eyelid surgery. Read More

Authors:

Blepharoplasty with medial epicanthoplasty is popular in Asia. However, known complications include scarring, which can take the form of hypertrophic scars or keloids. Treatments for scars include pressure dressing, silicone gels, retinoic acids, radiotherapy, cryotherapy, triamcinolone injections, and surgical revision. Read More

Authors:

Objective: To explore the effectiveness of the modified Park method of blepharoplasty for correction of mild blepharoptosis.

Methods: Between October 2012 and January 2015, a new modified Park method of blepharoplasty was performed on 23 patients with foldless eyelid combined mild blepharoptosis. There were 14 males and 9 females, aged 16 to 35 years (mean, 25 years). Read More

Background: The epicanthus can weaken the effect of blepharoplasty, which makes it difficult to form the out-fold type double eyelids preferred by Asian women. The integration of blepharoplasty and Z-epicanthoplasty has become increasingly popular. Although many techniques have been introduced to remove the epicanthus during blepharoplasty, there are still some surgical complications. Read More

Background: In recent years, cosmetic surgery in Iran, which is provided almost entirely by the private sector, has gained popularity despite evidence of its potential risks. In most cases, cosmetic surgeries are done to increase self-satisfaction and self-esteem, thus seeking cosmetic surgery potentially shows an individual's psychological profile. Current evidence needs studies on the psychological profile of Asian cosmetic surgery patients. Read More

Methods: The MAFT was performed with the assistance of a patented medical device, the MAFT-GUN, on 34 patients who had sunken upper eyelids and multiple folds. Each delivered fat parcel was accurately and consistently maintained at 1/240 mL during placement. Read More

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